Ricardo Arsenio Revilla, MD
Emergency Medicine in Destin, FL. Individual provider (NPI-1).
NPI number1326255142
StatusActive
Last updated in NPPESMay 4, 2022
Details
- NPI
- 1326255142
- Entity type
- Individual (NPI-1)
- Name
- Ricardo Arsenio Revilla
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 17, 2007
- Certification date
- May 4, 2022
- Last updated
- May 4, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | ME106166 | FL | Yes |
Practice location
145 Country Club Dr WDestin, FL 32541-4437
Phone 305-333-8436
Mailing address
145 Country Club Dr WDestin, FL 32541-4437
Phone 305-333-8436
Is something wrong?
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